Impact of a nurse-led intervention on quality of life in patients with chronic non-malignant pain: An open randomized controlled trial

Abstract

Aims: To determine the effect of a comprehensive nurse-led programme for patients with chronic non-malignant pain, on quality of life, level of pain, anxiety, and depression, as primary outcomes and patients' satisfaction as a secondary end point. Design: An open-label randomized controlled trial was carried out. Methods: The experimental group received both a nurse-led intervention on healthy lifestyles, education on self-esteem, pain awareness, communication, and relaxation techniques. The control group received usual care. Quality of life, level of pain, anxiety, and depression were the main outcomes. Data were obtained at baseline, immediately after the intervention, and 6 and 9 months. The study was carried out from 2015–2017. Results: The sample was composed of 279 patients. At 9 months, the effect size (non-parametric effect size statistic A) favoured the intervention group for SF-36 mental health score (A = 0.79; 95% CI: 0.73–0.85), anxiety (A = 0.58; 95% CI: 0.51– 0.65), pain intensity (A = 0.57; 95% CI: 0.51–0.64), and depression (A = 0.58; 95% CI: 0.51–0.65). Smaller differences were found on physical scores between the intervention and the usual care group. Patients showed a high level of satisfaction with the introduced intervention. Conclusion: A comprehensive nurse-led programme for patients with chronic nonmalignant pain has a positive impact on their quality of life, level of pain, and mental health. Impact: Studies have reported that the problem of chronic pain is not optimally controlled. A structured nurse-led programme has been tested to facilitate healthy behaviours to help patients manage their chronic pain and to provide them with the necessary tools for their self-care. This nurse-led intervention improved their mental health and decreased their level of pain. K E Y W O R D S anxiety, chronic pain, depression, health promotion/health education, nursing, pain management, patient satisfaction, quality of life